Whatever be the age, gender or race, injuries are a part of human life and development. Bone fractures and injury to the internal organs are considered as emergency situations which can be fatal or disabling for the lifetime. But there are less serious injuries which may go unnoticed at the time of trauma but can be severe and disabling as the time goes by. There are many examples like sprain, a hairline fracture or a stress fracture etc. These will not cause immediate & serious signs like unbearable pain, discolouration or huge swelling like in the fractured bones. But if not diagnosed, managed & immobilised in a proper way, these can cause serious health problems of locomotor system in the long run. A sprain is a stretching or tearing of ligaments — the tough bands of fibrous tissue that connect two bones together in the joints. The most common location for a sprain is in the ankle.
Signs and symptoms
- Pain/tenderness
Swelling and/or bruising - Cold foot or paresthesia (possible neurovascular compromise)
- Muscle spasm
Causes
Physical injuries or trauma.
Pathophysiology
The lateral ankle complex, which is composed of the anterior talofibular, calcaneofibular, and posterior talofibular ligaments, is the most commonly injured site. Approximately 85% of such sprains are inversion sprains of the lateral ligaments, 5% are eversion sprains of the deltoid or medial ligament, and 10% are syndesmotic injuries. The ATFL is the most likely component of the lateral ankle complex to be injured in a lateral ankle sprain. Osteochondral or chondral injuries of the talar dome should be considered when diagnosing an ankle injury.
During forced dorsiflexion, the PTFL can rupture. With forced internal rotation, ATFL rupture is followed by injury to the PTFL. Extreme external rotation disrupts the deep deltoid ligament on the medial side, and adduction in neutral and dorsiflexed positions can disrupt the CFL. In plantarflexion, the ATFL can be injured.
Diagnosis
- Physical examination
- Plain radiography
- Stress view radiography
- CT scan
- MRI
- Bone scanning
Treatments
Physical therapy
Strengthening exercises, Proprioception rehabilitation etc
Medicinal therapy
Analgesics, Nonsteroidal anti-inflammatory agents etc
Surgical repair
Immobilisation
Prognosis
The prognosis for isolated and adequately treated ankle sprains is excellent.
Complications
Fractures
Disease & Ayurveda
Snayugatavaata due to injury
Nidana
Abhighaata – injury
Purvaaroopa
Not mentioned
Samprapti
Due to abhighata, doshas (mainly Vaata) get vitiated at the sites, affect the muscular tissue and produce the disease.
Lakshana
Pain and swelling of the area
Restricted movements
Divisions
Not mentioned
Prognosis
Saadhya in new cases with complete rest & immobilisation
Kricchrasadhya in chronic & complicated cases
Chikithsa
All the treatments for sprain include complete immobilisation. Ayurveda treatment involves sothahara (reducing the swelling & inflammation) and ballya ( strengthening therapies)
Samana
Lepanam with Rookshana dravyas
Snehana
Swedanam
Mardanam
Upanaham
Bandhanam
Sodhana
Agnikarma
Commonly used medicines
Nagaradi lepachoornam
Murivenna
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
To treat a sprained ankle or leg at home, remember the acronym RICE:
- Rest. Stay off your ankle or leg until you can get to the doctor or until the swelling goes away.
- Ice. Put ice on the swollen area as soon as you can for 15 to 20 minutes. Then repeat every three to four hours.
- Compression. Wrap your ankle or leg snugly, but be sure not to cut off circulation. Support stockings may be an option.
- Elevation. Raise your ankle or leg above your heart (or as far above your heart as possible). Two pillows will usually give you the correct elevation. This encourages fluid to move away from your leg & prevent swelling.
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, honey
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from extreme climate changes.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active.
Yoga
No movement is allowed in cases of sprain.
Regular stretching and mild cardio exercises are advised after healing. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://pubmed.ncbi.nlm.nih.gov/29514819/
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
rajesh@ayurvedaforall.com
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